Wegovy pill side effects and how they are managed
Dr. Hecham Harb
Consultant Endocrinologist & Medical Director
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The most common side effects of the Wegovy pill affect the digestive system: nausea, vomiting, constipation and diarrhoea. In the UK product information, nausea was reported by 46.6% of adults taking the pill, compared with 18.6% of those taking a placebo. These symptoms are typically most noticeable when the dose goes up and are often mild or moderate. Contact your endocrinologist if symptoms are persistent or make it difficult to eat or drink; do not adjust the dose yourself.
- The UK product information lists eight very common side effects of the Wegovy pill, including nausea, vomiting, diarrhoea and constipation.
- Constipation was reported by 20.1% of adults taking the pill and by 9.8% on a placebo, and it tended to last longer than other digestive effects.
- The US prescribing information states that common side effects with the pill were similar in type and frequency to those with the Wegovy injection.
- The UK product information reports that digestive side effects led 3.4% of adults taking the pill to stop treatment permanently.
- Severe stomach pain that spreads to the back, persistent vomiting or a sudden change in eyesight needs urgent medical advice.
- The Wegovy pill should not be used during pregnancy, and it should be stopped at least two months before a planned pregnancy.
01 What are the most common side effects of the Wegovy pill?
The Wegovy pill (oral semaglutide) is a once-daily tablet that contains semaglutide, the active ingredient of the Wegovy injection. Most of its common side effects affect the digestive system.
The UK product information for the Wegovy pill lists nausea, vomiting, diarrhoea, constipation, abdominal pain, indigestion, headache and tiredness as very common. Very common side effects may affect more than 1 in 10 people.
The product information gives the following rates for adults taking the pill in its weight management trial, compared with adults taking a placebo:
| Side effect | Wegovy pill | Placebo |
|---|---|---|
| Nausea | 46.6% | 18.6% |
| Vomiting | 30.9% | 5.9% |
| Constipation | 20.1% | 9.8% |
| Diarrhoea | 17.6% | 8.8% |
| Hair loss | 6.4% | 2.0% |
| Dysaesthesia | 4.9% | 0% |
| Gallstones | 2.5% | 1% |
Not every patient experiences these side effects, and the product information describes most of the digestive effects as mild to moderate. Other common side effects include dizziness, a change in taste, burping, wind, reflux, a bloated abdomen and stomach inflammation, known as gastritis.
02 How long do Wegovy pill side effects last?
The UK product information reports that most digestive side effects occurred during the period of dose increases and were short-lived. Constipation was also mild to moderate in most cases, but it tended to last longer than the other digestive effects.
Side effects such as nausea or constipation can be particularly pronounced in the first few days at a new dose. They often improve as your body adjusts, although some symptoms last longer.
The dose rises in monthly steps from 1.5 mg to 25 mg, so side effects can reappear for a short time after each increase. Our Wegovy pill dosage guide sets out each step, and our guide to your first weeks on the Wegovy pill describes the starting dose.
03 Does the Wegovy pill have more side effects than the injection?
The US prescribing information for Wegovy states that, in the trial of the 25 mg pill, the types and frequency of common side effects were similar to those reported with the Wegovy injection.
Our comparison of the Wegovy pill and the Wegovy injection covers the other differences between the two forms. The page on Wegovy side effects describes the injection in detail.
04 How Endocare manages Wegovy pill side effects
If you experience nausea or constipation, your endocrinologist can adjust the pace of dose increases and, where needed, prescribe medication to help manage these side effects. If a dose is not well tolerated, the US prescribing information advises considering a delay before the next increase. If the 25 mg dose is not well tolerated, it suggests considering a switch to the 1.7 mg Wegovy injection.
To help with nausea, we recommend eating smaller meals, eating slowly and stopping when you feel full. Our article on constipation on GLP-1 medications explains how fibre, fluids and physical activity can help with constipation.
We recommend drinking enough fluids each day, particularly if you are vomiting or have diarrhoea. The UK product information warns that these side effects can lead to dehydration, which in rare cases can affect how well the kidneys work.
Endocare’s doctors are always available to support patients with advice.
05 Hair loss and skin sensation changes on the Wegovy pill
The UK product information reports hair loss in 6.4% of adults taking the pill, compared with 2.0% on a placebo. Our article on hair loss on GLP-1 medications explains what is known about it.
Dysaesthesia means an altered or unpleasant sensation in the skin. The product information reports it in 4.9% of adults taking the pill and in none of those taking a placebo. We recommend telling your endocrinologist if you notice it.
06 Serious side effects of the Wegovy pill
The product information also describes rarer but serious side effects. Severe stomach pain that spreads to the back and does not go away can be a sign of pancreatitis, an inflammation of the pancreas. Seek medical advice immediately if you have this pain, as the MHRA also advises.
Gallstones were reported in 2.5% of adults taking the pill and in 1% on a placebo. Our article on gallbladder problems on GLP-1 medications describes the warning signs.
A sudden loss or change of eyesight needs urgent assessment. Very rare cases of an optic nerve condition called NAION have been reported with semaglutide, and the UK product information asks for urgent referral to an eye specialist. If you have type 2 diabetes and take insulin, it also advises closer monitoring for diabetic eye disease.
If you take insulin or a sulfonylurea for diabetes, the risk of low blood sugar can rise. Your endocrinologist may reduce the dose of those medications.
Swelling of the face, lips, tongue or throat, or difficulty breathing, can be signs of a severe allergic reaction. Call an ambulance on 998. The UAE government’s list of emergency numbers gives 998 for an ambulance.
Before any planned procedure, tell the doctor or anaesthetist that you take the Wegovy pill. The product information reports a risk of food or fluid being inhaled into the lungs during general anaesthesia or deep sedation. Our article on weight loss medication before surgery explains what to tell the surgical team.
07 Who should not take the Wegovy pill?
The US prescribing information states that the Wegovy pill should not be used by people with a personal or family history of medullary thyroid cancer, or of a condition called multiple endocrine neoplasia type 2 (MEN 2).
The Wegovy pill should not be used during pregnancy or while breastfeeding. The UK product information advises stopping it at least two months before a planned pregnancy, because semaglutide stays in the body for several weeks.
The product information does not recommend the pill for people with severe kidney disease, and advises caution in people who have had pancreatitis. It should not be taken together with another GLP-1 medication.
08 FAQ
How soon do Wegovy pill side effects start?
They can start in the first few days of treatment or after a dose increase. The UK product information reports that most digestive side effects occurred while the dose was rising. Not every patient experiences them.
Should I stop the Wegovy pill if I feel sick?
Not without speaking to your endocrinologist first. Nausea often eases as your body adjusts, and your endocrinologist can slow the dose increases. If you keep vomiting or cannot keep fluids down, seek medical advice immediately, as this can lead to dehydration.
Can the Wegovy pill affect my thyroid?
The US prescribing information carries a warning about thyroid C-cell tumours. This finding comes from studies in animals, and whether semaglutide causes these tumours in humans is not known. For this reason, the pill is not used in people with a personal or family history of medullary thyroid cancer or MEN 2. The UK product information also reports that the pill increased exposure to levothyroxine by 33%, so your endocrinologist may check your thyroid levels.
Do side effects get worse at the 25 mg dose?
Not necessarily. Side effects are often most noticeable in the days after any dose increase, including the step to 25 mg. If a step is difficult to tolerate, your endocrinologist can keep you at your current dose for longer.
Patients should not decide by themselves to start a GLP-1 medication. A doctor’s review is critical to ensure the treatment is safe and appropriate for the individual.
At our Dubai clinic, your endocrinologist will assess you, explain the side effects to expect and review how you feel at every follow-up appointment.
Monthly follow-up appointments can be held in person at the clinic or online. We recommend the first consultation in person, as it includes a physical examination and body composition analysis.
You can book a weight loss consultation on +971 4 285 3885 or send us a message on WhatsApp.
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